Provider Demographics
NPI:1982695383
Name:MCDONALD, WILLIAM L (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7901 DILEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9612
Mailing Address - Country:US
Mailing Address - Phone:614-835-3838
Mailing Address - Fax:614-834-4750
Practice Address - Street 1:7901 DILEY RD STE 200
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9612
Practice Address - Country:US
Practice Address - Phone:614-835-3838
Practice Address - Fax:614-834-4750
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2015-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224364207Q00000X
OH34-007196207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH0059444Medicaid
OHH0059444Medicaid